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Pinnamaneni et al. J Cancer Metastasis Treat 2021;7:7 I http://dx.doi.org/10.20517/2394-4722.2020.94 Page 13 of 14

Table 6. Advantages and disadvantages of allograft prosthetic composite reconstruction
Advantages Disadvantages
All-biologic reconstruction Allograft osteolysis
Host-Graft soft tissue attachments Non-union
Modularity of prosthesis Hardware failure
Convertibility of prosthesis Allograft fracture
Immediate stability Allograft resorption
Early range of motion and functionality Proximal migration (Hemiarthroplasty)
Lower complication rates compared to osteochondral allograft Instability
Can use standard implants instead of endoprosthesis implants Aseptic loosening
Good long-term survivability Availability of allograft
Good long-term functional outcomes

from 60% and 79% in different case series [15,26-28] . In general, numerus studies have shown better MSTS
scores and better abduction in patient with intact deltoid [24-27] .

Other Surgical Options
Other proximal humeral reconstruction options include the Clavicula pro humero and glenohumeral
arthrodesis. Alternatively, a Tikhoff-Linberg procedure can be performed for salvage cases. The indications
for these procedures are rare.

CONCLUSION
Limb salvage surgery with wide resection and reconstruction is considered the standard of care for a
number of oncologic indications including primary bone tumors and metastatic disease. Wide resections
of the proximal humerus and the surrounding soft-tissue stabilizing structures necessitate a complex
reconstruction. While there are a number of case series reviewing different types of reconstruction options
after proximal humeral resection for tumor, there are no high-level comparative studies in the literature.
Considering this, there is little agreement on the ideal method, but reverse total shoulder reconstruction
has been increasingly used.

DECLARATIONS
Authors’ contributions
Completing composition of this article: Pinnamaneni S, Damron TA
Providing cases in this article: Damron TA

Availability of data and materials
Not applicable.

Financial support and sponsorship
Not applicable.

Conflicts of interest
Not applicable.

Ethical approval and consent to participate
Written informed consent to participate and consent for publication from the patients was obtained prior
to surgical intervention.

Consent for publication
The consent for publication was obtained from patients included in the study.